The process typically begins with an interview between a health care provider and the family of the suspected pica patient. The interview involves the parents, caregivers, and sometimes siblings to gather a plethora of information about the patient such as: what does the patient ingest, when does the patient ingest, and how frequently does the patient engage in pica behavior. (Brown University Child and Adolescent Behavior Letter)
Once the interviews are complete, professionals will then determine which type of assessment to proceed with in order to determine an effective treatment method for the individual. Each case of pica is unique, therefore, a team consisting of trained professionals is recommended to attend to the pica behavior.
Medical Examinations
o Intraoral Examination: looks for erosion, fractures, tooth wear, periodontal disease, gingival recession, tissue lacerations, or atrophy of the tongue. (Barker, 2005)
§ All signs of iron deficiency anemia
o Laboratory studies
§ Rule out mineral deficiencies
§ Look for dietary deficiencies
§ Detect the presence of toxic substances such as lead, mercury, or copper
§ Liver function test
§ Electrolyte measurements
§ Diagnostic imaging to determine the presence of indigestible objects and obstructive masses
· X-rays
o Burke and Smith report how X-rays were used to assess prevalence of pica
Diagnostic Markers for detecting Pica
Analyses
o During an assessment, there are various different techniques used to determine the condition of the pica being examined.
§ Baiting: placing non-food items in an area where individuals could be observed and assessed safely (Piazza et. al., 1998).
§ Use of placebos to determine if the behavior or the item itself maintains pica.
§ Pica stimulus to determine to what degree the item is reinforcing the behavior.
Component Analysis
o Offers different parts of an object to determine the specific component that maintains pica.
Functional Analysis
o Identify specific sources of reinforcement through 5 different methods:
§ Attention: Attention deprivation then attention delivery
§ Demand: Presentation of requests then escape
§ Tangible: Removal of preferred items/activities, then the delivery of the tangible item
§ Alone: absence of social or tangible stimulation
§ Control: individual receives preferred item, is reinforced constantly, the ideal world for the individual
Once the interviews are complete, professionals will then determine which type of assessment to proceed with in order to determine an effective treatment method for the individual. Each case of pica is unique, therefore, a team consisting of trained professionals is recommended to attend to the pica behavior.
Medical Examinations
o Intraoral Examination: looks for erosion, fractures, tooth wear, periodontal disease, gingival recession, tissue lacerations, or atrophy of the tongue. (Barker, 2005)
§ All signs of iron deficiency anemia
o Laboratory studies
§ Rule out mineral deficiencies
§ Look for dietary deficiencies
§ Detect the presence of toxic substances such as lead, mercury, or copper
§ Liver function test
§ Electrolyte measurements
§ Diagnostic imaging to determine the presence of indigestible objects and obstructive masses
· X-rays
o Burke and Smith report how X-rays were used to assess prevalence of pica
Diagnostic Markers for detecting Pica
- Ultrasound, abdominal flat plate radiography, and other scanning methods may reveal obstructions that are related to pica (DSM-5).
- Blood test and other laboratory test can also be used to determine levels of poisoning or the nature of infection (DSM-5).
Analyses
o During an assessment, there are various different techniques used to determine the condition of the pica being examined.
§ Baiting: placing non-food items in an area where individuals could be observed and assessed safely (Piazza et. al., 1998).
§ Use of placebos to determine if the behavior or the item itself maintains pica.
§ Pica stimulus to determine to what degree the item is reinforcing the behavior.
Component Analysis
o Offers different parts of an object to determine the specific component that maintains pica.
Functional Analysis
o Identify specific sources of reinforcement through 5 different methods:
§ Attention: Attention deprivation then attention delivery
§ Demand: Presentation of requests then escape
§ Tangible: Removal of preferred items/activities, then the delivery of the tangible item
§ Alone: absence of social or tangible stimulation
§ Control: individual receives preferred item, is reinforced constantly, the ideal world for the individual